What are the indications for performing this operation in a patient with thyroid eye disease?
• Compressive optic neuropathy. – This is the main indication for this type of surgery. Compressive optic neuropathy refers to visual loss due to compression of the optic nerve at the back of the orbit. Occasionally it is due to extreme stretching of the optic nerve. The optic nerve is compressed by swollen muscles at the apex of the orbit where there is a confined space. An orbital decompression may be considered as the main management of this problem or it may be used for patients in whom alternative treatments e.g. steroids, radiotherapy have failed or have caused intolerable side effects. • Exposure keratopathy. – This refers to a situation where the cornea is exposed due to severe proptosis (protrusion of the eye) with poor closure of the eye resulting in drying of the cornea and even ulceration in advanced cases. • Chronic pain. – Some patients have constant aching orbital pain due to congestion of the orbital tissues which can be relieved by a decompression procedure. • Subluxat
